A study published in the Journal of the Canadian Medical Association (CMAJ) shows there is a five-per-cent mortality rate for Ontario people who often visit hospital Emergency Rooms for alcohol-related reasons in a one-year period. The study also said more intervention would be helpful in offsetting the mortality rate of those people, who are often from disadvantaged backgrounds.
The authors of the study were Jennifer Hulme, MD MPH; Hasan Sheikh, MD; Edward Xie, MD MSc; Evgenia Gatov, MPH; Chenthila Nagamuthu, MPH; Paul Kurdyak, MD PhD; from the University of Toronto, the Institute for Mental Health Policy and the Centre for Addiction and Mental Health in Toronto.
The study was carried out between Jan. 1, 2010 and Dec. 31, 2016 in Ontario for persons who made two or more ER visits in one year for alcohol-related mental or behavioural disorders. More than 25,000 Ontario residents were narrowed down to the cohort of those who had two or more hospital ER visits in a one year.
Of that number, the study found a mortality rate of 5.4 per cent. This ranged from 4.7 per cent for those with two visits up to 8.8 per cent for those with five or more visits.
"Death due to external causes (e.g., suicide, accidents) was most common," said the study.
Despite the percentage findings, the authors concluded that "little is known about the risk of death among people who visit emergency departments frequently for alcohol-related reasons, including whether mortality risk increases with increasing frequency of visits."
The authors said their primary objective was to describe socio-demographic and clinical characteristics of this high-risk group and examine the level of mortality, premature mortality and causes of death.
In the formal interpretation of their study, the authors said the highest mortality rate involved mostly urban and mostly low income people who had frequent hospital visits for alcohol issues. The study also said alcohol is a leading driver of morbidity and mortality around the world. In 2016, the study said there were an estimated 3 million deaths — five per cent of all global deaths — attributable to alcohol consumption.
Alcohol also plays a significant factor in the morbidity of younger people, said the study.
"The 2016 Global Burden of Disease Study showed that alcohol was the single greatest risk factor for ill health worldwide among people aged 15-49 years. In Canada, hospital admissions for alcohol-attributable conditions out-number those for myocardial infarction. Alcohol-related harms cost Canadians about $14.6 billion annually, with $3.3 billion in health care costs."
The study also said that alcohol-related hospital visits are increasing with acute intoxication and withdrawal disorders becoming common reasons for ER visits.
"Data from the United States and Canada, furthermore, suggest that alcohol-related emergency department visits have increased in recent years. For example, a study in Ontario showed that, between 2003 and 2016, the age-standardized rates of alcohol-attributable emergency department visits increased by 86.5 per cent in women and 53.2 per cent in men," said the report.
It also stated that those who visit the ER for alcohol reasons have high levels of comorbidity (having two or more diseases or medical conditions at the same time) and social disadvantage and represent a readily identifiable patient population
"A systematic review suggested that screening and brief intervention for alcohol-related problems in the emergency department is a promising approach for reducing problematic alcohol consumption," said the study.
